Exercise may be the best treatment for depression, new studies show
Depression has always been a commmon condition, and probably has resurrected in the last few years. And although there are effective treatments, not all treatments are effective for all people. A new study, the largest of its kind to date, finds that exercise ‘interventions’ appear to reduce symptoms of depression about as much as conventional treatments, such as medication and therapy. The authors recommend that their findings be considered by organizations writing clinical guidelines that do not currently consider exercise as a first-line treatment for depression.
In the new meta-analysis, published in the British Journal of Sports Medicine, the authors selected data from 41 previous studies, consisting of more than 2,200 participants. Each of the study participants either started exercise routines of various descriptions or remained inactive (as a control). Overall, the effects of exercise were considered moderate to large, statistically speaking, comparable to the effects of standard treatments, such as antidepressants or talk therapy. Certain types of activity had a greater impact — professionally supervised exercise, group exercise programs, and moderate-intensity, aerobic exercise — but even light exercise was effective.
The authors explain the size of the effect this way: if 100 people were in the exercise group and 100 in the control group, about half of those in the exercise group would experience a significant reduction in their symptoms of depression. , compared to only 20 in the control group. .
The new study is encouraging not only because it is the largest of its kind, but also because it corrects for some of the experimental biases that make the results difficult to interpret, such as flaws in study design, exercise in the control group, etc. More research is still needed, the authors point out, including studies specifically designed to demonstrate that exercise is no worse than standard treatments (non-inferiority studies) and to determine which types of exercise would be the more effective for which subgroups of people. “Future large-scale research studies should also determine which patients benefit most from which exercise condition,” they write, “and identify any groups for whom exercise may not be the optimal treatment choice.” .
Still, the authors believe the results of their study should prompt clinical guidelines to include exercise as a primary treatment, rather than just an adjunct. “Updated guidelines as well as routine clinical decisions regarding interventions for the treatment of depression should take current findings into account,” they write. Especially since about two-thirds of people with depression do not receive treatment, they point out, and the treatments that do exist can incur significant costs or side effects.
In addition, a new study from Amsterdam UMC, published in the Affective Disorders Diary, put on antidepressants and a head-to-head running intervention. People with depression and/or anxiety were given antidepressants (escitalopram or sertraline) or joined a running group (45 minutes, twice a week) for 16 weeks. At the end of this period, people in both groups had similar rates of remission of their depression and anxiety: the remission rate for people taking antidepressants was 45% and in the running group, 43%. Not surprisingly, people in the exercise group also experienced physical benefits, such as weight loss and lower blood pressure.
Like the authors of the first study, this team also suggests elevating exercise as a treatment option and considering it “common practice for people with depression and/or anxiety disorders.”
As with other treatments, exercise will not be suitable for everyone. But more research, especially finer research, can begin to determine who may benefit and who may do better with other treatments. As we learn more through well-designed studies, more tailored treatments will be possible and hopefully treatment success rates for people with depression will increase.